Provider Demographics
NPI:1598328080
Name:KEYES, OPRAH CHERELLE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:OPRAH
Middle Name:CHERELLE
Last Name:KEYES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BALTIMORE NATIONAL PIKE STE 170A-204
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3930
Mailing Address - Country:US
Mailing Address - Phone:443-842-5446
Mailing Address - Fax:
Practice Address - Street 1:6400 BALTIMORE NATIONAL PIKE STE 170A-204
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-3930
Practice Address - Country:US
Practice Address - Phone:443-842-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2020-11-30
Deactivation Date:2019-08-19
Deactivation Code:
Reactivation Date:2020-04-08
Provider Licenses
StateLicense IDTaxonomies
MD21440104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker